An Analysis of Chromosome on Sterility Caused by Azoospermia or Oligospermia

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Application of fluorescence in situ hybridization techniques in clinical genetics: use of two alphoid repeat probes detecting the centromeres of chromosomes 13 and 21 or chromosomes 14 and 22, respectively

Two cloned DNA fragments, one derived from an alpha satellite subfamily common to chromosomes 13 and 21, and the other derived from a similar subfamily common to chromosomes 14 and 22, have been used as biotinylated probes in in situ hybridization studies. Under high stringency conditions, chromosome specific centromeric labelling can be obtained. The applications of this technique in clinical situations are illustrated on metaphases from a fetus with trisomy 21, a fetus with trisomy 13, and a child with clinical features of cat-eye syndrome.     

Chronic occupational exposure to organic solvents

Summary Twenty-two persons (20 men and 2 women) were examined for their external and internal exposure to the glycol ether 1-methoxypropan-2-ol (PGME) during the production, leak testing and mounting of brake-hoses. For the measurement of external exposure, personal air monitoring was the method of choice. Average concentrations of PGME of 82.2 mg/m³ (22.3 ppm), 68.6 mg/m³ (18.6 ppm) and 11.3 mg/m³ (3.1 ppm) were found in the air of the brakehose production, leak test and mounting areas, respectively. For the estimation of internal exposure to PGME, this glycol ether was measured in both urine and blood. The biological samples were taken post-shift. The highest internal exposure levels were found in the brakehose production section and in the leak test area. The average post-shift concentrations for PGME in workers in the brakehose production section were 4.6 mg/l in urine and 13.5 mg/l in blood; the corresponding figures for workers in the leak test area were 4.2 mg/l in urine and 11.0 mg/l in blood. In blood and urine samples of workers engaged in the mounting area, PGME levels were below the detection limits. The elimination kinetics of PGME were also studied in three highly exposed persons, and mean excretion half-lives of PGME of approximately 4.4 h were found. On the basis of our results we made a rough calculation of a future biological tolerance value: we would except that concentrations of 38-109 mg per litre of blood and 10–31 mg per litre of urine would correspond to the German MAK value for PGME (375 mg/m³).     

An analysis of paediatric diagnostic decision-making: how should students be taught?

This study assesses the relative importance of history, examination and investigations in paediatric diagnosis, in the Paediatric Out-patient Department of the Central Middlesex Hospital, London, by means of a questionnaire-based record of 94 consecutive referrals. A diagnosis identical to the final diagnosis was made in 76% of referrals after taking a history. The general practitioner had proposed a diagnosis in 45% in the referral letter. Clinical examination changed the diagnosis in only 15% but increased diagnostic confidence in 33%. Ninety-one per cent of cases were diagnosed without recourse to investigations. Forty-two per cent of children referred had investigations performed. In the majority of paediatric cases the provisional diagnosis reached after taking a history was identical to that after examination or results of investigations were known. Although examination provided a final diagnosis in only 15% of all cases it played an important role in adding confidence in 33%. More educational effort should therefore be directed at clinical history-taking skills and the subsequent purpose of examination.     

临床医学专业学位教育的困境与发展走向

自临床医学研究生、临床医学专业学位教育实施以来，社会评价并不高，甚至存在相当数量的负面评价。究其因，一是源于对临床医学专业学位教育的认识误区，二是源于我国目前临床医学专业学位教育制度本身的缺陷。目前，我国高等医学教育体系尚不完善，专业学位教育、研究生教育及毕业后职业技能基本培训之间关系错综复杂，功能定位不清，形成相互干扰和冲突。建议进一步梳理思路，正确认识专业学位教育、研究生教育和住院医师规范化培训的教育特征与功能定位，建立各自恰当的培养目标与培养模式，最终实现在全国建立先进、科学、完善、与国际接轨的完整的医学教育体系。     

元认知能力在医学生临床实习中的培养

元认知能力在医学生临床实习过程中起着非常重要的作用。培养医学生的元认知能力 ,必须丰富医学生的元认知知识 ,强化医学生的元认知体验 ,促进医学生加强元认知监控 ,从而使他们成为独立自主、有创造力的学习者。     

临床护理路径在臀肌挛缩症患者健康教育中的应用

目的 探讨应用临床护理路径对臀肌孪缩症患者健康教育的效果。方法 将60例臀肌挛缩症患者分为对照组（n=30）和实验组（n=30），对照组采用常规教育方法，实验组按制定好的健康教育路径进行教育，将两组患者的健康教育达标率、对护理工作的满意度进行比较。结果 两组患者在健康教育达标率、对护理工作的满意度方面比较，差异有统计学意义（P〈0．01）。结论 对臀肌挛缩症患者运用护理手段进行健康教育后提高了患者的健康教育达标率，提高了护理工作的满意度，效果优于常规教育方法。     

The basis for treatment in multiple sclerosis

Contemporary licensed treatments for multiple sclerosis fail to provide a solution for the disease because their effects are limited to a modest reduction in the frequency of new episodes. They do not reduce disability or materially influence the progressive phase of the disease. A contemporary strategy for management requires a more detailed analysis of the separate contributions to the clinical features and overall course made by inflammation, axonal injury, compensatory mechanisms, and remyelination. From this formulation emerges the need either for early and fully effective suppression of the inflammatory response, limiting the damage to all components of the axon-glial unit; or the development of strategies for axonal and myelin repair that solve the issues of controlled differentiation, delivery and timing of these cell and growth factor-based interventions.     

脑电分频积分定量法测定甜菜碱对清醒家兔脑电图的影响

本文采用脑电分频积分定量法测定甜菜碱对清醒家兔脑电的影响。清醒家兔静注甜菜碱250mg/kg后,出现高幅幔波夹杂低幅快波脑电,自发脑电积分值((?)vs)显著提高。动物安静少动。结果表明甜菜碱有中枢抑制作用。